Determinants of Site of Death Among Hospice Cancer Patients

Abstract
Despite its social, cultural, and psychological salience, few empirical studies have examined the factors influencing site of death. Data describing cancer patients served by hospices participating in the National Hospice Study (NHS) were used to explore the relative importance of patients' sociodemographic, support-network, and physical-health characteristics, as well as health-system factors, in predicting whether patients die at home or in a medical setting. The site of death of 69.9 percent of the 3257 patients was correctly predicted. Whether the hospice serving a patient had beds was the dominant predictor, even when controlling for differences in the types of patients served by hospices with and without beds. Findings suggest that bed availability influences clinical decisions of appropriateness and may override personal preferences.